<%@ page language="java" contentType="text/html; charset=UTF-8"
    pageEncoding="UTF-8"%>
    <%@ page import="java.util.*,com.autoMobile.bean.rrmBx" %>
<!DOCTYPE html>
<html lang="zh">
<head>
    <meta charset="UTF-8">
    <title>保险填报</title>
    <link rel="stylesheet" href="<%=request.getContextPath()%>/css/styles.css">
</head>
<body style="background: transparent;">
    <div class="form-container">
        <h2>保险填报</h2>
        <form action="/JH/addbdServlet">
                    <div class="form-group">
                     <div class="form-group">
                <label>车牌号</label>
                <input type="text"  name="cph"class="form-control" placeholder="请输入车牌号" required>
            </div>
            <div class="form-group">
                <label>车型</label>
                <input type="text"  name="cx"class="form-control" placeholder="请输入车型" required>
            </div>
            <div class="form-group">
                <label>颜色</label>
                <input type="text"  name="ys"class="form-control" placeholder="请输入颜色" required>
            </div>
            <div class="form-group">
                <label>车架号</label>
                <input type="text"  name="cjh"class="form-control" placeholder="请输入车架号" required>
            </div>
                <label>保险公司</label>
                <input type="text"  name="bxgs"class="form-control" placeholder="请输入保险公司" required>
            </div>
            <div class="form-group" >
                <label>保险种类</label>
                <select class="form-control" name="bxzl"required>
                    <option value="">请选择保险种类</option>
                    <option>交强险</option>
                    <option>商业险</option>
                    <option>全险</option>
                    <option>其他</option>
                </select>
            </div>
                        <div class="form-group">
                <label>保单号</label>
                <input type="text"  name="bdh"class="form-control" placeholder="请输入保单号" required>
            </div>
            <div class="form-group">
                <label>保额</label>
                <input type="text"  name="be"class="form-control" placeholder="请输入保额" required>
            </div>
			<div class="form-group">
                <label>初始日期</label>
                <input type="datetime-local"  name="csrq"class="form-control" placeholder="请输入初始日期" required>
            </div>
           <div class="form-group">
                <label>截止日期</label>
                <input type="datetime-local"  name="jzrq"class="form-control"placeholder="请输入截止日期"  required>
            </div>            
            <div class="form-footer">
                <button type="submit" class="btn">提交表单</button>
            </div>
        </form>
    </div>
</body>
</html> 